Superficial Pigmentary Keratitis

Brown Pigment on the Surface of the Eyes Can Cause Blindness in Pugs, Boston Terriers, & Lhasa Apsos.

Question:

I recently adopted a 10-month-old female fawn pug, Phoebe. I was told that she was probably blind and had keratitis pigmentosa. She sees fairly well. Is there anything I can do for her, or to help her with this condition?

Dr. Nichol:

Phoebe’s eye disease, also called superficial pigmentary keratitis, can be serious business in brachycephalic (pushed-in face) breeds like Pugs, Boston Terriers, and Lhasa Apsos. It’s unnecessary; dogs who look like they’ve been chasing parked cars didn’t result from natural selection. These are man-made breeds. Extra eyelashes and facial folds plague many of those sweet little personalities. Hair rubs their eyes constantly. Add bulging eyes that can’t stay properly lubricated and you have a formula for ocular disaster. Those dry, irritated corneas (the eye’s outer surface) accumulate dark brown pigment that light can’t penetrate. Without help, little Phoebe can become blind.

Priority one is stopping more dark pigment from dimming Phoebe’s vision. If she also has eyelid disorders or skin folds, surgery will be essential. Artificial tears to prevent dryness will also help. To reduce the pigment already in place Phoebe needs daily corticosteroid eye drops. If her disease is advanced superficial radiation can make a big difference.

Phoebe’s eye problems are important. Blindness is one thing, constantly painful eyes is another. Don’t wait. This is not a disease that gets better on its own.

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Pigmentary Keratitis is Pugs in Sweden

Question:

I have had pugs that have eye damage on the cornea and it has grown pigmentary keratitis very fast. Is it the head type that causes the eye problem and accidents? The Swedish Kennel Club has said this is hereditary. It is not allowed to give pharmaceutical preparations and show in Sweden because it is considered doping. SKC gave me the license to show the dogs on the drops but they decided that I am not allowed to use the male as a stud dog. Why not?

Dr. Nichol:

Pugs, Pekingnese, and other brachycephalic breeds (pushed in faces, bulging eyes) are at high risk of diseases of the cornea (the clear front of the eye). Those protruding eyes are easily injured. They take longer to heal because they are more exposed to air. Moisture and lubrication is essential for healthy eyes; pugs are at a disadvantage.

Some of these fun loving little dogs suffer even greater damage from eyelids that roll against their corneas, along with those big, thick, hairy cheek folds that can rub their eyes. Add a tendency for poor tear production and you have pigmentary keratitis (dark brown corneal pigment) that restricts light, leading to blindness. Cyclosporin drops have been a godsend because they stimulate tear production. Dogs without corneal wounds can be rid of much of their dark pigment with eye lubricants and corticosteroid drops. And surgery can correct the constant irritation of eyelashes and cheek fold hair. Keeping those eyes healthy can be a lifelong challenge.

The Swedish Kennel Club is setting a good example for us Americans. Dogs with hereditary diseases really should not be bred. I don’t think eye treatment constitutes doping, but selling your dog’s puppies to unsuspecting pug lovers might be seen as duping.